Document Detail


Prevalence and Distribution of Iron Overload in Patients with Transfusion-dependent Anemias Differs across Geographic Regions: Results from the CORDELIA Study.
MedLine Citation:
PMID:  25418187     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: The randomized comparison of deferasirox to deferoxamine for myocardial iron removal in patients with transfusion-dependent anemias (CORDELIA) gave the opportunity to assess relative prevalence and body distribution of iron overload in screened patients.
METHODS: Patients aged ≥10 years with transfusion-dependent anemias from 11 countries were screened. Data were summarized descriptively, overall and across regions.
RESULTS: Among 925 patients (99.1% with β thalassemia major; 98.5% receiving prior chelation; mean age 19.2 years), 36.7% had myocardial iron overload (myocardial T2* ≤20ms), 12.1% had low left ventricular ejection fraction. LIC (mean 25.8 mg Fe/g dw) and serum ferritin (median 3702 ng/mL) were high. Fewer patients in the Middle East (ME; 28.5%) had myocardial T2* ≤20ms versus patients in the West (45.9%) and Far East (FE, 40.9%). Patients in the West had highest myocardial iron burden, but lowest LIC (26.9% with LIC <7mg Fe/g dw) and serum ferritin. Among patients with normal myocardial iron, a higher proportion of patients from the ME and FE had LIC ≥15 than <7mg Fe/g dw (ME, 56.7 vs 17.2%; FE, 78.6 vs 7.8%, respectively), a trend which was less evident in the West (44.6 vs 33.9%, respectively). Transfusion and chelation practices differed between regions.
CONCLUSIONS: Evidence of substantial myocardial and liver iron burden across regions revealed a need for optimization of effective, convenient iron chelation regimens. Significant regional variation exists in myocardial and liver iron loading that are not well explained; improved understanding of factors contributing to differences in body iron distribution may be of clinical benefit. This article is protected by copyright. All rights reserved.
Authors:
Yesim Aydinok; John B Porter; Antonio Piga; Mohsen Elalfy; Amal El-Beshlawy; Yurdanur Kilinç; Vip Viprakasit; Akif Yesilipek; Dany Habr; Erhard Quebe-Fehling; Dudley J Pennell
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-11-24
Journal Detail:
Title:  European journal of haematology     Volume:  -     ISSN:  1600-0609     ISO Abbreviation:  Eur. J. Haematol.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-24     Completed Date:  -     Revised Date:  2014-11-25    
Medline Journal Info:
Nlm Unique ID:  8703985     Medline TA:  Eur J Haematol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
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